Hatton Grange is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection. Hatton Grange is registered to provide accommodation and personal care for 70 people. It is not registered to provide nursing care.

At the time of the inspection Hatton Grange was accommodating 67 people in one building across 3 floors divided into six units. The service could support up to 30 people in their three specialist dementia units and 40 people within the residential care units.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Hatton Grange has been registered to deliver care under the provider, Anchor Carehomes limited since 24 April 2017 and this was the first inspection of this home under this provider. The service had been previously inspected in September 2016 under the provider registration of Anchor Carehomes (Hyde) limited. At that time the service was rated as requires improvement in the safe and well led domains and good in the effective, caring and responsive. The service was rated as requires improvement overall. We identified one breach of the Health and Social Care Act (HSCA) 2008 (Regulated Activities) Regulations 2014. This related to the governance of the service as we had identified concerns relating to how the provider monitored risks relating to the health and safety of people using the service. We also made a recommendation about staffing levels.

At this inspection we looked to see if the required improvements had been made. We found that maintenance tasks were carried out quickly, but concerns about safe staffing levels remained. This was identified as a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We identified a further breach in relation to the management and administration of medicines. You can see what action we told the provider to take at the back of the full version of the report.

At the time of the inspection we found there were not enough staff to meet people’s needs in a timely manner. We saw times when people were left for periods of time in the communal areas and heard many occasions where staff asked a person to wait a few minutes before they could attend to their care needs.

We found that medicines and medical equipment were not always stored securely when not in use, the registered manager took immediate action to remedy this. The service was in the process of changing how they supported people with administering their medicines and was changing from prefilled blister packs to boxed medication and electric medication administration records (eMARs). This had not yet been fully embedded, and errors were identified, the service had identified this prior to this inspection and appropriate action plans were in place.

The home was clean and tidy, however we found that there were rooms that should have been securely locked but were accessible to people. These were immediately resolved during inspection and action taken to reduce the risk of a repeat incident.

People were positive about the registered manager and the way the home was organised and managed. Staff told us they enjoyed working at the home and felt supported.

Recruitment procedures were in place which ensured staff were safely recruited. Staff received the training, support and supervision they needed to carry out their roles effectively.

Staff were aware of their responsibilities in safeguarding people from abuse and could demonstrate their understanding of